Patients in need for fertility treatments are on high alert regarding the current Covid-19 pandemic and its effect on their treatment. The current ASRM guideline issued on March 17th recommends to postpone any in-vitro (IVF) cycles unless there is an urgency to proceed.
Does it mean you need to completely abandon your fertility treatment – No. We will remain open and will asses the individual situation and provide guidance how to best cope with the evolving situation. Tree of Life Center is aware that the pandemic is a world changing event and that we might never return to the life that we were used to. However, the desire to have a child will always remain and our task as fertility clinic will be to adjust to the new circumstances. Our clinic has recognized the challenges early and has stocked up on supplies, personal protective equipment, disinfectants and is equipped to continue to provide services during challenging times. We will never try to downplay the risks, but we will meet the challenge with preparation and thoughtfulness head-on.
The fertility journey will face additional restrictions since we need to maintain social distancing and keep ourselves safe from acquiring or transmitting the Covid-19 disease. Every fertility clinic is different and needs to implement best practices to keep their patients safe respective of their own setting. Implementation of these measures are much easier in a smaller clinic with less staff and less patient volume. Larger clinics with multiple doctors seeing a large number of patient might need more in-depth reorganization to effectively cope with the new safety challenges.
Tree of Life Center has enough SARS-CoV-2 Coronavirus PCR tests available to test our staff and patients if needed. All of our staff tested negative and we will keep testing, even with the slightest suspicion of any symptoms - all in order to ensure early identification. Any of our registered fertility patients can arrange for Coronavirus testing at Tree of Life Center if needed. We will evaluate each case individually and find the safest way to administer the test.
We have introduced following steps to mitigate risks of treatment during Covid-19 pandemic:
As per current ASRM and ESHRE recommendation, we discourage patients from starting in-vitro fertilization cycles if these are not urgent. Every patient should have an individual assessment regarding the effect of postponing treatment. In general, younger patients with high number of eggs in the ovary will have virtually unchanged success rates if they decide to wait until there is a Covid-19 vaccine available and no or little community spread. This however might postpone your fertility treatment into 2021.
Some patients were recently rushing to start IVF cycles since they fear that the pandemic is just beginning and will worsen. One of the problems is that the egg retrieval procedure is performed with anesthesia requiring propofol via an intravenous (IV) access. Given that more medical resources will be allocated to critically ill patients fighting Covid-19, we might see shortages of propofol, IV lines and some other supplies . The alternative is to consider minimal or natural cycle stimulations with no anesthesia. This will mandate the patient undergoing more IVF cycles. Retrieving a higher number of eggs will almost always require anesthesia. Therefore, at the beginning of every cycle it needs to be ensured that all supplies are available and locked in place for the ongoing cycle.
The eggs and embryos are generally safe from the Coronavirus. The embryologists routinely wear a mask and the laboratory room is a cleanroom with filtered and UV-treated air to reduce any potential pathogens. After the egg retrieval is performed, there should not be any rush to move on with the embryo transfer and initiate a pregnancy.
At present, many patients will decide to delay the frozen embryo transfer until the initial epidemic wave is over. Initially, there was no suggestion of any direct harm to the embryo in case of a Covid-19 infection, although recently there have been reports that raise the question if a newborn can be infected in utero prior to birth by the infected mother. Therefore, becoming pregnant during a pandemic should be a well thought decision. Even if there might be no direct impact of the virus on an ongoing pregnancy, pregnant infected women might need treatment and in some cases even life support measures that can significantly affect the health of the child. At this point, there is simply too little information to make definitive conclusions. While isolation during pregnancy is an option to consider, there are still appointments and procedures that a pregnant woman needs to undergo to ensure the ongoing health of the baby.
We will keep you updated as the situation evolves!